Energy stored in spring with controlled release

ABSTRACT

There is provided a surgical instrument including a handle having an elongated tubular member extending distally from the handle and one or more end effectors mounted on the distal end of the elongate tubular member. A driver is movably mounted within the handle and elongate tubular member in order to operate the end effectors. The surgical instrument includes an energy storage mechanism for storing and providing energy to move the driver and thereby actuate the surgical instrument. Various actuation mechanisms are disclosed which are operable on the energy storage mechanism to control the rate of release of the energy stored in the energy storage mechanism.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a divisional of U.S. patent application Ser. No.10/550,469 filed Sep. 22, 2005, now U.S. Pat. No. 7,559,449 which is a35 U.S.C. §371 National Filing of PCT/US04/009442 filed Mar. 26, 2004,which claims benefit of U.S. Provisional Application Ser. No. 60/458,086filed Mar. 26, 2003, the disclosures of which are hereby incorporated byreference herein, in their entirety.

BACKGROUND

In certain devices, such as surgical instruments, it is desirable tostore energy within the instrument to facilitate firing the instrument.One such device is a clip applier disclosed in U.S. Pat. No. 4,611,595.This clip applier stores energy in a spring which is retained by a latchmechanism. Movement of a handle disengages the latch resulting in rapidand uncontrolled release of the stored energy to actuate the clipapplier. However, in some instruments it would be desirable to havestructure for allowing for a controlled release of the stored energy tocontrol the rate of actuation of the instrument.

Further, many surgical instruments, such as 60 mm staplers used in thicktissue, require more energy than can be comfortably developed by asingle squeeze of a human hand. Currently, surgeons may use two hands tofire, or use instruments which require multiple, lower effort squeezes,to fire. Thus, it would also be desirable to have a surgical instrumentthat can be pre-energized by pumping at least once and possibly severaltimes to store potential energy in a spring. This pre-energizing may bedone by a surgical nurse or other assistant. This is particularlyimportant during long procedures where fatigue, from multiple firings,may be uncomfortable to the surgeon.

SUMMARY

There is provided a surgical instrument for use in actuating various endeffectors. The surgical instrument generally includes a handle having anelongated tubular member extending distally from the handle. The variousend effectors may be provided on the distal end of the elongate tubularmember and actuated by a driver, such as, for example, a drive rod,which is mounted for movement relative to the elongate member. Thesurgical instrument also includes an energy storing mechanism forstoring and providing energy to move the drive rod and thus actuate theend effectors. Various embodiments of actuation mechanisms are disclosedwhich are operable on the energy storage mechanism to restrain, andcontrol the rate of, release of the energy stored in the energy storagemechanism.

The energy storage mechanism generally includes a cylinder having aspring biased piston positioned therein. A piston rod is attached to thepiston and extends through the cylinder to engage gear structureassociated with the drive rod. The handle is provided at a second end ofthe piston rod to compress the spring and piston within the cylinder.Release of the energy stored in the spring forces the piston rod to movein a direction which actuates the gear structure to drive the drive rodand thus actuate the end effectors.

In a first embodiment, a fluid system is associated with the cylinderand piston to restrain and dampen the movement of the piston. A transfersystem is provided to transfer the fluid from one side of the piston tothe other side of the piston within the cylinder. The transfer systemmay additionally include a bypass mechanism allowing the surgeon tocompress the spring and piston and thus transfer the fluid within thecylinder.

An actuation system of an alternative embodiment utilizes a brakemechanism operable on the gear structure connecting the piston rod tothe drive rod. Depression of a trigger releases the pressure of thebrake on the gear structure allowing the instrument to be fired.

Similarly, a further embodiment utilizes a similar brake mechanism tocontrol the rate of release of the energy stored in the energy storagemechanism. This embodiment utilizes a particularly useful linkage toprovide a mechanical advantage and thus greater pressure on the gearmechanism in situations where the spring is of a particularly highstrength.

There are also disclosed additional embodiments of the surgicalinstrument which utilize a flywheel to provide a dampening effect on thegear mechanism as the gear mechanism is driven by the piston rod. In oneembodiment, an idler gear wheel is attached to the flywheel and a camsurface is provided on a trigger to frictionally engage the flywheel andthus control the rate of release of energy stored in the spring. In analternative embodiment, a multi-gear structure is associated with theflywheel to provide greater mechanical advantages as disclosed herein.

DESCRIPTION OF THE DRAWINGS

Various embodiments are disclosed herein with reference to the drawingswherein:

FIG. 1 is a schematic view of an energy storage system, in an actuatorhandle, employing a hydraulic dampening structure;

FIG. 2 is a schematic view of an energy storage system, in a handlemechanism, employing a brake dampening system;

FIG. 3 is a schematic view of an energy storage system, in a handlemechanism, employing a second embodiment of a brake dampening system;

FIG. 4 is a schematic view of an energy storage system, in a handlemechanism, employing a flywheel dampening system; and

FIG. 5 is a schematic view of an energy storage system, in a handlemechanism, employing a multi-gear dampening system.

DETAILED DESCRIPTION

There are disclosed various embodiments of a handle assembly in whichenergy is stored in a spring from one or more manual input actions andrestrained by various actuation structure. When the surgeon actuates atrigger the spring is unrestrained at controllable rates therebyallowing the stored energy in the spring to be delivered into theworking mechanism to perform the desired function.

In general, a damping means is incorporated into the system, to controlthe rate of energy release to a smooth, deliberate action. The dampingmay be hydraulic, pneumatic, mechanical or other suitable means. Ifdesired, the release may be made controllable by the surgeon through theuse of a valve, brake, flywheel or other suitable control means, so asto allow him or her to go faster, slower, or even pause the releaseaction.

Referring to FIG. 1, an instrument 10 is disclosed for actuating variousend effectors 12. Instrument 10 generally includes a handle body 14, anelongate tubular member 16 extending distally from handle body 14 and adriver, such as, a drive rod 18 longitudinally movable therein toactuate end effector 12. While elongate tubular member 16 is illustratedas being fixed to handle body 14, elongate tubular member 16 mayalternatively be mounted for rotation with respect to handle body 14.

An energy storage system 20 is provided to store energy and provide itto drive rod 18 upon release. Energy storage system 20 generallyincludes a cylinder 22 having a compressible spring 24, such as, forexample, a die spring, mounted therein. Spring 24 is positioned betweena bottom cap 26 of cylinder 22 and a piston 28 slidably mounted in thecylinder 22. A piston rod 30 extends through cylinder 22 and is affixedto the piston 28. An energizing handle 32 is mounted at a pivot point Ato a bracket 34 on the handle body 14. A lower end 36 of the piston rod30 is pivotally mounted to the energizing handle 32 at a pivot point Band rides in slot E of energizing handle 32. An upper end 38 of thepiston rod 30 is connected to an L-rack 40 having L-rack teeth 42. Alarge gear wheel 44 and a small gear wheel 46 are affixed to each otherand are rotatably mounted to the handle body 14. Teeth 48 on the smallgear wheel 46 engage L-teeth 42 on the L-rack 40 while teeth 50 on thelarge gear wheel 44 engage drive teeth 52 on the drive rod 18.Configuration of the gear ratios are such that a distance movement d1 ofpiston rod 30 results in a distance movement d2 of the drive rod. In oneuseful embodiment, a movement d1=1 inch results in a distance movementd2=approximately 2.6 inches.

By rotating energizing handle 32 about pivot A, in the direction ofarrow F, piston rod 30 is pulled down compressing spring 24 betweenpiston 28 and bottom cap 26. Pulling piston rod 30 down pulls L-rack 40down causing L-rack teeth 42 to rotate large and small gear wheels 44and 46 clockwise by engagement with teeth 48 on small gear wheel 46. Aslarge gear wheel 44 rotates clockwise, teeth 50 draw drive rod 18proximally by engagement with drive teeth 52. This motion draws driverod 18 to a proximal position.

As noted above, various embodiments of an actuation mechanism areprovided to restrain compressed spring 24 and allow for controlledrelease of the energy stored therein. With continued reference to FIG.1, a first embodiment of an actuation mechanism having a hydraulicsystem 54 is provided to control the release of spring 24 and providegreater control of the actuation of the instrument end effectors 12.Cylinder 22 is sealed by a top cap 56 and bottom cap 26 and is providedwith an incompressible hydraulic fluid 58 on either side of piston 28.In one embodiment, piston 28 is provided with an O-ring 60 to isolatefluid 58 on either side of piston 28 and allow smooth movement of piston28 within cylinder 22.

A transfer system 62 is provided between an upper port 64 and a lowerport 66 in top and bottom caps 56,26 to move hydraulic fluid 58 from oneside of piston 28 to the other within cylinder 22 as die spring 24 iscompressed. Transfer system 62 includes upper and lower tubes 68,70which are in fluid communication with the upper and lower ports 64,66.Movement of piston 28 within cylinder 22 forces hydraulic fluid 58 fromone side of piston 28 to the other via upper and lower tubes 68,70.

The actuation system also includes a valve 72 positioned between upperand lower tubes 68, 70, respectively, and a valve trigger 74 to actuatevalve 72. Depression of valve trigger 74 progressively opens valve 72 toallow for flow of hydraulic fluid 58. When valve trigger 74 is notdepressed valve 72 is closed and no fluid 58 can flow therethrough.

In order to allow for movement of fluid 58 from one side of piston 28 tothe other during compression of spring 24, there is provided a bypasssystem 76 having a one way check valve 78 positioned around valve 72 andbetween the upper and lower tubes 68,70, respectively. One way checkvalve 78 acts as a latch or restraining mechanism which will only allowfor flow of fluid 58 in the direction from the lower tube 70 to theupper tube 68 during compression of spring 24.

In operation, energizing handle 32 is actuated to compress spring 24 anddraw drive rod 18 proximally as described hereinabove. Valve 72 isclosed and check valve 78 allows fluid to flow from lower tube 70 toupper tube 68. Once spring 24 is fully compressed, the pressure of fluid58 in an upper chamber 80 of cylinder 22 maintains spring 24 incompression. Fluid 58 cannot flow back through bypass system 76 andvalve 72 is closed. To controllably release spring 24 pressure and thusactuate the instrument, valve trigger 74 is depressed to allow fluid 58to flow from upper tube 68 to lower tube 70 and lessen the fluidpressure in the upper chamber 80 as the fluid is transferred to a lowerchamber 82. Upon release of spring 24, piston rod 30 moves up rotatinglarge and small gear wheels 44 and 46 in a counter clockwise rotationand propelling drive rod 18 distally to actuate the end effector 12. Therelease of pressure and thus actuation of the instrument can beprecisely controlled by the operator. By manipulating valve trigger 74,actuation can be instant and rapid, slow and progressive or evenintermittent by repeated small depression of valve trigger 74.

A further function of hydraulic system 54 is to dampen the movement ofpiston 28 within cylinder 22 to provide a smooth and controlled releaseof spring 24 pressure and thus a very smooth actuation of theinstrument.

Referring now to FIG. 2, there is disclosed a second embodiment of asurgical instrument having an energy storage system. The secondembodiment incorporates a brake system to controllably release thespring pressure. It should be noted that the common elements of theembodiment disclosed herein are substantially similar to the firstembodiment. Instrument 110 is designed to provide actuation toassociated end effectors 112.

Instrument 110 generally includes a handle body 114 having an elongatedtubular member 116 extending distally therefrom. A drive rod 118 ismovably mounted in handle body 114 and elongated tubular member 116 andis powered by an energy storage system 120 in the manner described abovewith respect to energy storage system 20. Energy storage system 120includes a cylinder 122 having a spring 124, such as a die spring,positioned between a bottom cap 126 and a piston 128. A piston rod 130is affixed to piston 128. An energizing handle 132 is pivotally mountedabout point A to handle body 114 at bracket 134. A lower end 136 ofpiston rod 130 is affixed to energizing handle 132 and pivots at point Band rides in a slot E in energizing handle 132. Energy storage system120 also includes upper piston rod end 138 attached to an L-rack 140having L-rack teeth 142. Large and small gear wheels 144, 146 havinggear teeth 150 and 148, respectively, function together with drive teeth152 on drive rod 118 in the manner described above to power drive rod118 in response to release of the energy stored in spring 124.

In the embodiment of FIG. 2, air fills cylinder 122 and upper and lowerclearances 154, 156 formed in cylinder 122 around piston rod 130 allowsair to flow freely in and out of cylinder 122. In order to restrainspring 124 in the compressed state and allow for controlled release ofspring 124 pressure and thus actuation of the instrument there isprovided a brake system 158 which frictionally acts on large gear wheel144. Brake system 158 includes a brake shoe 160 which frictionallyengages large gear wheel 144. A bias spring 162 is provided to biasbrake shoe 160 into engagement with large gear wheel 144 with sufficientforce to prevent rotation of large gear wheel 144 and prevent release ofcompressed spring 124.

A trigger 164 is pivotally mounted to the housing at pivot C andconnected to brake shoe 160 by a transfer bar 166. Depression of trigger164 moves brake shoe 160 progressively out of engagement with large gearwheel 144 and against the bias of bias spring 162. This allowscontrolled release of the spring pressure in compressed spring 124 andthus controllable actuation of the instrument.

Referring now to FIG. 3, there is disclosed an alternate embodiment of asurgical instrument having another type of a brake assembly forcontrolled release of the die spring and actuation of the instrument.Instrument 210 generally includes a handle body 214 having an elongatedtubular member 216 extending distally therefrom. A drive rod 218 ismovably mounted in handle body 214 and elongated tubular member 216 andis powered by an energy storage system 220 in the manner described abovewith respect to energy storage system 20. Energy storage system 220includes a cylinder 222 having a spring 224, such as a die spring,positioned between a bottom cap 226 and a piston 228. A piston rod 230is affixed to piston 228. An energizing handle 232 is pivotally mountedabout point A to handle body 214 at bracket 234. A lower end 236 ofpiston rod 230 is affixed to energizing handle 232 and pivots at point Band rides in slot E in energizing handle 232. Energy storage system 220also includes upper piston rod end 238 attached to an L-rack 240 havingL-rack teeth 242. Large and small gear wheels 244,246 having gear teeth250 and 248, respectively, function together with drive teeth 252 ondrive rod 218 in the manner described above to power drive rod 218 inresponse to release of the energy stored in spring 224.

As noted above, an actuation system is provided to control the rate ofrelease of spring 224. An actuation or brake assembly 254 is providedsimilar to that of FIG. 2. Brake assembly 254 includes a brake 256 whichis provided to pivotally engage large gear wheel 244 to control motionthereof. A trigger 258 is pivotally mounted to handle body 214 at afixed, generally central point. Trigger 258 is relatively long toprovide additional leverage and reduce the pressure on trigger 258needed to actuate the instrument. A first end 260 of trigger 258 extendsout of handle body 214 and a second end 262 is connected to brake 256 bya linkage 264. A biasing spring 266 provided in handle body 214 acts onsecond end 262 to bias brake 256 into engagement with large gear wheel244.

In a manner similar to that of the embodiment in FIG. 2, depression oftrigger 258 lifts-brake 256 away from large gear wheel 244 tocontrollably release the energy stored in spring 224 and actuate theinstrument.

Referring now to FIG. 4 there is disclosed an actuation system havingflywheel mechanism for controlled release of the energy stored in thespring and thus actuation of the instrument. Instrument 310, as withprior embodiments, is designed to provide actuation to associatedinstrument 310. Instrument 310 generally includes a handle body 314having an elongated tubular member 316 extending distally therefrom. Itshould be noted that in all embodiments disclosed herein, elongatedtubular member may be mounted for rotation on handle body 314. A driverod 318 is movably mounted in handle body 314 and elongated tubularmember 316 and is powered by an energy storage system 320. Energystorage system 320 includes a cylinder 322 having a spring 324, such asa die spring, positioned between a bottom cap 326 and a piston 328. Apiston rod 330 is affixed to piston 328. An energizing handle 332 ispivotally mounted about point A to handle body 314 at bracket 334. Alower end 336 of piston rod 330 is pivotally mounted to energizinghandle 332 and pivots at point B and rides in a slot E in energizinghandle 232 as shown. Energy storage system 320 also includes upperpiston rod end 338 attached to an L-rack 340 having L-rack teeth 342.Large and small gear wheels 344 and 346, having gear teeth 350 and 348,respectively, function together with drive teeth 352 on drive rod 318 inthe matter described above. To power drive rod 318 in response torelease of the energy stored in spring 324.

An alternative actuation system is provided to control the release ofspring 324 by implementation of a fly wheel structure to smooth outactuation of instrument 310. A relatively large diameter flywheel 354 isrotatably mounted in the housing and connected to the large gear wheel344 by a small diameter idler gear wheel 356. A trigger 338 is pivotallymounted to handle body 314 and includes a cam surface 360 engageablewith flywheel 354. A trigger spring 362 biases trigger 338 such that camsurface 360 on trigger 338 firmly engages flywheel 354 to restrain thecompressed spring 324. The difference in diameters of flywheel 354 andidler gear wheel 356 provides a mechanical advantage which reduces thepressure on trigger 338 needed to actuate the instrument.

Actuation of trigger 338 against the bias of trigger spring 362 bringscam surface 360 out of frictional engagement with flywheel 354. Thisallows for controlled release of the energy stored in spring 324 andcontrolled actuation of the surgical instrument 310. Importantly, theinertia present in flywheel 354 helps to retard startup rotation andthus actuation of the instrument 310. This retarded acceleration of therelease of the spring pressure allows for smoother and slower actuationof drive rod 318.

Referring now to FIG. 5, instrument 410, as with prior embodiments, isdesigned to provide actuation to associated instrument 410. Instrument410 generally includes a handle body 414 having an elongated tubularmember 416 extending distally therefrom. It should be noted that in allembodiments disclosed herein, elongated tubular member may be mountedfor rotation on handle body 414. A drive rod 418 is movably mounted inhandle body 414 and elongated tubular member 416 and is powered by anenergy storage system 42U. Energy storage system 420 includes a cylinder422 having a spring 424, such as a die spring, positioned between abottom cap 426 and a piston 428. A piston rod 430 is affixed to piston428. An energizing handle 432 is pivotally mounted about point A tohandle body 414 at bracket 434. A lower end 436 with piston rod 430 isaffixed to energizing handle 432 and pivots at point B and rides in aslot E in energizing handle 432 as shown. Energy storage system 420 alsoincludes upper piston rod end 428 attached to an L-rack 440 havingL-rack teeth 442. Large and small gear wheels 444 and 446, having gearteeth 450 and 448, respectively, function together with drive teeth 452on drive rod 418 in the manner described above, to power drive rod 418in response to release of the energy stored in spring 424.

An alternative actuation system is provided to control the release ofspring 424 by implementation of a multi-gear fly wheel structure tosmooth out actuation of instrument 410.

An intermediate gear wheel 454 is affixed to idler gear wheel 456 suchthat idler gear wheel teeth 458 engage large gear wheel teeth 450. Aflywheel 460 having a drive gear wheel 462 affixed thereto is rotatablymounted in handle body 414. Drive gear teeth 464 of drive gear wheel 462are engageable with intermediate gear wheel teeth 466 of intermediategear wheel 454 to rotate flywheel 460. A trigger 468 is pivotallymounted to handle body 414 and includes a braking mechanism similar toprevious described embodiments including a cam surface 470 engageablewith flywheel 460. The contact surfaces of cam surface 470 and flywheel460 are relatively smooth to provide a smooth and progressive breakingaction therebetween. A trigger spring 472 biases trigger 468 intoengagement with flywheel 460.

Operation is similar to the previous disclosed embodiments in thatinstrument 410 is energized by rotating energizing handle 432 tocompress spring 424. A frictional engagement of cam surface 470 ontrigger 468 against flywheel 460 prevents release of the energy. Onceinstrument 410 is to be actuated, trigger 468 is depressed lessening theengagement of cam surface 470 with flywheel 460. By varying the degreeof pressure arm trigger 468 the amount of contact between cam surface470 and flywheel 460 can be varied to thereby vary the rate of fire ofinstrument 410. Additionally, certain mechanical advantages are obtainedthrough the use of multiple gear mechanisms. The multi-gear mechanismsallow a relatively large force to be applied to control the rate ofrelease of energy stored in the spring in response to a relatively smallforce applied to the triggers. Additionally, the use of multiple gearshaving differing diameter allows a multiplication of force applied tothe drive rod and thus the end effectors.

It is further envisioned that the input action to store energy may bemotor driven, such that energy may commence being transferred into thespring during the period of time when a cartridge or disposable loadingunit is being replaced, or even earlier, as right after the previousfiring. Because the time period of transfer of energy from the motor tothe spring is extended, a smaller, lighter motor and battery (or powersupply) may be used.

It is additionally envisioned that, while the embodiments shown hereinutilize a pistol style grip, other grip styles, such as, for example,straight, offset, etc. may also be used with the disclosed energystorage and actuation systems. Further, other cocking devices may besubstituted for the pivoting energizing handle, such as, for example, arotary cam, leadscrew compound lever, toggle, pull cable, etc.

While several embodiments of the disclosure have been shown in thedrawings, it is not intended that the disclosure be limited thereto, asit is intended that the disclosure be as broad in scope as the art willallow and that the specification be read likewise. Therefore, the abovedescription should not be construed as limiting, but merely asexemplifications of preferred embodiments. Those skilled in the art willenvision other modifications within the scope of this disclosure.

1. A surgical instrument for driving an end effector comprising: ahandle having an elongate tubular member extending from the distal endof the handle; a driver movable within the elongate tubular member andoperable on the end effector; an energy storage mechanism comprising aspring having an energized position and a cylinder having an interiorspace, the spring being at least partially positioned within the handleand operable on the driver to advance the driver within the elongatetubular member to drive the end effector; a piston connected to thespring and dividing the interior space of the cylinder into a first sideand a second side, an incompressible hydraulic fluid being disposed inthe first side of the cylinder and arranged in relation to the pistonand spring so that the spring biases the piston against the hydraulicfluid when the spring is in the energized position; and an actuationmechanism comprising a valve, the valve for opening and closing apassage communicating the first side of the cylinder with the secondside of the cylinder to control movement of the driver.
 2. The surgicalinstrument of claim 1, wherein the valve has an open position thatallows the piston to move.
 3. The surgical instrument of claim 1,further comprising a valve trigger to open the passage.
 4. The surgicalinstrument of claim 1, wherein the handle is manually operated andconnected to the spring.
 5. The surgical instrument of claim 1, whereinthe piston comprises a piston rod and a seal.
 6. The surgical instrumentof claim 1, wherein the passage comprises a first tube in communicationwith the first side of the cylinder.
 7. The surgical instrument of claim6, further comprising a second tube in communication with the secondside of the cylinder.
 8. The surgical instrument of claim 7, furthercomprising a check valve disposed between the first tube and the secondtube.
 9. A method of using a surgical instrument having an end effector,comprising: actuating a handle to energize a spring connected to thehandle, the spring being connected to a piston disposed in a cylinder sothat, when the spring is energized, the spring is biased against a fluiddisposed in a portion of the cylinder; depressing a valve trigger torelease at least some of the fluid from the portion of the cylinder;moving a drive rod, the drive rod being connected to the piston; andtransferring at least some of the fluid from the portion of the cylinderto a second portion of the cylinder.
 10. The method of claim 9, whereinthe piston is connected to at least one gear wheel, and moving thepiston rotates the at least one gear wheel.
 11. The method of claim 10,wherein the at least one gear wheel moves the drive rod distally toactuate the end effector.
 12. The method of claim 9, wherein theactuation of the valve trigger can be varied by a user of the surgicalinstrument.